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Young Mania Rating Scale (YMRS)

Clinician-administered severity scale for manic episodes.

Patient ID / Reference (Optional)

Notes / Observations

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1. Elevated Mood

0 - Absent / Normal mood 1 - Mildly or possibly elevated on questioning 2 - Definite subjective elevation; optimistic, self-confident 3 - Elevated, inappropriate to content; humorous 4 - Euphoric; inappropriate laughter; singing

2. Increased Motor Activity-Energy

0 - Absent / Normal 1 - Subjectively increased 2 - Animated; gestures increased 3 - Excessive energy; hyperactive at times; restless 4 - Motor excitement; continuous hyperactivity

3. Sexual Interest

0 - Normal / No increase 1 - Mildly or possibly increased 2 - Definite subjective increase on questioning 3 - Spontaneous sexual content; elaborate sexual ideas 4 - Overt sexual behavior (towards patients, staff, etc.)

4. Sleep

0 - Reports no decrease in sleep 1 - Sleeping up to 1 hour less than normal 2 - Sleeping up to 2 hours less than normal 3 - Decreased need for sleep (3+ hours less than normal) 4 - Denies any need for sleep

5. Irritability Double Weighted

0 - Absent 2 - Subjective increase mildly noted 4 - Specific episodes of irritability; raw responses 6 - Frequently irritable during interview; sharp tone 8 - Hostile, uncooperative; interview impossible

6. Speech (Rate and Amount) Double Weighted

0 - No increase / Normal pace 2 - Feels mildly talkative 4 - Increased volume or rate at intervals; verbose 6 - Pushy, rapid, difficult to interrupt 8 - Logorrhea; entirely un-interruptible; screaming

7. Language-Thought Disorder

0 - Absent 1 - Circumstantial; mild digressions 2 - Distractible; loses thread of thought 3 - Flight of ideas; tangential thoughts 4 - Incoherent; communication broken down

8. Thought Content Double Weighted

0 - Normal / No clinical markers 2 - Grandiose projects; special plans 4 - Explicitly grandiose or paranoid themes 6 - Delusions; hallucinations present 8 - Completely unshakeable, active delusions

9. Disruptive-Aggressive Behavior Double Weighted

0 - Cooperative 2 - Sarcastic, mildly loud or argumentative 4 - Demanding; loud; intrusive; pacing 6 - Threatening; structural shouting 8 - Assaultive; physically destructive; dangerous

10. Appearance

0 - Appropriate dress and grooming 1 - Mildly disheveled or poorly groomed 2 - Poorly groomed; eccentric clothing choices 3 - Distinctly disheveled; hyper-decorated 4 - Completely unkempt; bizarre presentation

11. Insight

0 - Excellent insight; admits illness 1 - Admits possible illness or behavioral changes 2 - Admits behavior change but blames circumstances 3 - Admits changes but denies psychiatric issue 4 - Total lack of insight; completely denies illness

Total YMRS Score

Clinical Level: Remission / Normal

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Not medical advice. For use by trained clinicians only.